加速康复外科理念结合PCPON护理模式在胰十二指肠切除术围手术期中的应用效果  

Application effect of enhanced recovery after surgery concept combined with PCPON nursing model in perioperative period of pancreaticoduodenectomy

作　　者：仵晓荣[1] 付佳 杜立学[1] 陈昕 李仙莉 WU Xiaorong;FU Jia;DU Lixue;CHEN Xin;LI Xianli(Hepatobiliary Surgery Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China;No.1 General Surgery Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院肝胆外科,陕西西安710068 [2]陕西省人民医院普外一科,陕西西安710068

出　　处：《临床医学研究与实践》2022年第3期142-145,共4页Clinical Research and Practice

基　　金：国家自然科学基金资助项目(No.81803341);陕西省人民医院2018年护理专项获资助项目(No.2018HL-8)。

摘　　要：目的探讨加速康复外科(ERAS)理念结合以个体为中心的围术期护理(PCPON)在胰十二指肠切除术(PD)围手术期中的应用效果。方法选取我院肝胆外科收治的80例接受PD的患者作为研究对象,按时间先后顺序将其分为对照组和试验组,各40例。对照组采用ERAS理念护理模式,试验组在对照组基础上结合PCPON护理模式进行干预。比较两组患者的围手术期时间绩效指标(首次肛门排气时间、首次下床活动时间、再次手术例数、住院天数、住院费用)、并发症发生情况、心理状态、睡眠质量、健康教育满意度。结果试验组的首次肛门排气时间、首次下床活动时间、住院天数短于对照组,再次手术例数、住院费用少于对照组,差异具有统计学意义(P<0.05)。试验组的肺部感染、腹腔感染、腹水、出血发生率明显低于对照组(P<0.05)。护理后,两组的SCL-90、PSQI评分均较护理前降低,且试验组低于对照组(P<0.05)。试验组的健康教育满意度显著高于对照组,差异具有统计学意义(P<0.05)。结论ERAS理念结合PCPON护理模式应用于PD围手术期的效果显著,可加快患者术后康复。Objective To explore the application effect of enhanced recovery after surgery(ERAS)concept combined with person-centered perioperative nursing(PCPON)in the perioperative period of pancreaticoduodenectomy(PD).Methods A total of 80 patients undergoing PD in hepatobiliary surgery department of our hospital were selected as the research objects.The patients were divided into control group and experimental group according to chronological order,with 40 cases in each group.The control group was given ERAS concept nursing model,and the experimental group was given PCPON nursing model on the basis of the control group.The perioperative time performance indexes(first anal exhaust time,first out-of-bed activity time,number of reoperation,hospital stay and hospitalization expenses),complications,psychological state,sleep quality and health education satisfaction were compared between the two groups.Results The first anal exhaust time,the first out-of-bed activity time and the hospital stay in the experimental group were shorter than those in the control group,the number of reoperation and hospitalization expenses were less than those in the control group,and the differences were statistically significant(P<0.05).The incidence of pulmonary infection,abdominal infection,ascites and bleeding in the experimental group was significantly lower than those in the control group(P<0.05).After nursing,the scores of SCL-90 and PSQI in the two groups were lower than those before nursing,and those in the experimental group were lower than the control group(P<0.05).The satisfaction of health education in the experimental group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The ERAS concept combined with PCPON nursing model applied in perioperative period of PD has a significant effect,which can accelerate the postoperative rehabilitation of patients.

关 键 词：胰十二指肠切除术 围手术期 加速康复外科理念 PCPON护理模式 

分 类 号：R473.6[医药卫生—护理学]